Single Tracks Blog Archive

Limitations on Usefulness of Recent CJR Data

HFMA recently published a short article about the data for the Comprehensive Care for Joint Replacement program that was released in August. However, we have some additional caveats that should be considered in using this data.

The Proposed Mandatory Medicare Bundled Payment Program - 15 Things to Know

Note: CMS has released the Final Rule for the CJR program. Updates descriptions of the program are at this and this link.

CMS Announces Mandatory Joint Replacement Bundles

Yesterday CMS issued a proposed rule for the Comprehensive Care for Joint Replacement (CCJR)  a proposal to require all episodes of Major Joint Replacement in 75 MSAs to be paid on a "bundled" basis. This is a significant step from the voluntary Bundled Payment for Care Improvement program in that it requires virtually all hospitals (but not physicians or other providers) to be financially responsible for all of the care of these patients for 90 days after discharge. Hospitals in 75 Metropolitan Statistical Areas (MSAs) would be affected.

Thirty-Day BPCI Episodes? Let the Data Drive the Decision

In recent conversations, articles and seminars we’ve heard wary potential BPCI Model 2 participants propose to select a 30-day episode length as a “safer” alternative to the longer 90-day episode.  In some cases the shorter episode length does provide some risk mitigation against uncontrollable high costs such as readmissions. However, that safety comes at a price that may not be warranted. This is because of these two factors: 

Combining Clinically-Similar Bundled Payment Episodes to Reduce Risk and Improve Care

Jonathan Pearce, CPA, FHFMA and Coleen Kivlahan, MD, MSPH

The Medicare Bundled Payment for Care Improvement (BPCI) program allows participants to assume financial risk for all Medicare services occurring within 30 to 90 day period after hospital discharge. Model 2 participants give up 2% of the episode target amount as a discount to CMS in 90-day episodes, but are allowed to retain any savings from Medicare cost reductions below the target amounts.

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